Acne breakouts are painful and embarrassing, but more irritating are the scars that they leave behind. While some scars clear up over time on their own, but those caused due to severe acne leave permanent scarring as they heal.

In this article, let’s learn from the dermatologist, Dr Nirupama Parwanda, why and how we get acne scars and what are the best treatment options available to get rid of different types of acne scars.

Why do post acne scars occur?

Acne scars occur when collagen, which is present in the dermis layer of the skin, gets destroyed. They commonly occur among those people who have a family history of acne scars. The other reasons could be presence of inflammatory acne, picking or squeezing of active acne and not treating the acne on time.

How do post acne scars occur?

When the opening of your hair follicle and oil gland gets blocked, the secretions in the form of sebum and keratin get accumulated in the epidermis layer of your skin, forming comedones. If the blockage remains for a long time, a lot of secretion gets accumulated due to which a bacteria named Propionibacterium starts growing. This results in mild inflammation and if this continues, it leads to intense inflammation which can damage underlying tissue. To repair this damage, our body produces collagen- a substance that gives structural support to our skin. Depending upon how much collagen is produced, scar is formed, which is mostly of two types.

1. Atrophic/Depressed scar: It is in the form of depression or pit and occurs when the body produce less collagen

2. Hypertrophic scar: It is a thick raised scar that develops when skin produces excess collagen.

Treatment for acne scars?

If the scars are mild to moderate, they can be treated just by using creams, which must be taken only after consulting a dermatologist. Moreover, it’s important that they are applied in the right quantity as otherwise they can cause dryness and redness.

Available creams to treat mild and moderate acne scars:

Topical Retinoid creams: These include Adapalene, tazarotene and tretinoin.

Treatments for severe acne scars:

1. Chemical Peels: These peels help to exfoliate your skin and improve its tone and texture. Popular chemical peels are Glycolic acid peel, Jessner peel, Pyruvic acid peel, Phenol and TCA Cross peel. Patients have to go through 5-6 sessions in this type of treatment. It costs from Rs 1,500 - Rs 7,000 per session, depending on the type of peel.

2. Microneedling: It is a popular modality to treat acne scars and is done using derma roller, derma pen or radiofrequency. In this treatment, 4-6 sessions are required, and its cost varies from Rs 5,000 – Rs 12,000 per session.

3. Lasers: Lasers penetrate deep into the skin and help to boost collagen production. It also requires multiple sessions and costs around Rs 5,000 -Rs 12,000 per session.

4. Dermal Fillers: These are usually used in combination with other treatments to deliver fast results. Hyaluronic acid based fillers are used to fill the scar area and lift the skin. It costs around Rs 1,800 – Rs 3,500 depending on the type of dermal filler used.

5. Subcision: It is a minor surgical procedure in which a needle is inserted in the skin to break the tough scar tissue. Its cost varies from Rs 3,000 to Rs 5,000 per session.

Treatments depending upon the type of acne scars:

There are three types of atrophic acne scars, and all have different treatments.

1. Ice Pick scars: These are like small depressions on skin. The best way to treat them is by using Chemical peels like TCA Cross. Laser and microneedling are also helpful in treating these types of scars.

2. Rolling scars: These scars give a wavy texture to skin, and they are not so deep. Lasers and microneedling are the best treatments for these scars. Dermal fillers can also be used for better results.

3. Boxcar scars: These scars are very deep, and they appear on skin post inflammatory acne. To treat these scars, first subcision is done on the skin followed by lasers and microneedling. Many times, dermal fillers are also used in the treatment of Boxcar scars.

As per Dr Parwanda, no matter whether you are only applying creams or going through other treatments for acne scar reduction, you must not skip sunscreen. It is because sunscreen helps in reducing collagen damage that can be caused due to sun exposure. And as collagen is a substance that keeps your skin tight, its reduction can make your skin loose due to which acne scars are more visible.

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